De Witte J, Rietman G W, Vandenbroucke G, Deloof T
Department of Anesthesiology and Critical Care Medicine, OLV-Hospital, Aalst, Belgium.
Eur J Anaesthesiol. 1998 Mar;15(2):190-5.
The aim of this prospective, randomized and double-blind study was to assess the effects of a high dose of the analgesic tramadol administered at the conclusion of surgery on extubation time, sedation, and post-anaesthetic shivering. Forty adult patients, ASA physical status I or II, underwent laparoscopic surgery of about 1 h duration and received a standardized anaesthesia that was maintained with isoflurane in O2/N2O. Tramadol 3 mg kg-1 (n = 20) was administered intravenously at the beginning of wound closure, and was compared with saline (n = 20). Post-anaesthetic shivering did not occur in any patient who received tramadol, whereas it occurred in 60% of the control group (P < 0.001). There were no adverse effects on time to extubation and sedation, and discharge-ready time was shorter in the tramadol group (P < 0.05 compared with control). Pain scores in the post-anaesthesia care unit (PACU) were statistically not different between the two groups, but significantly more supplemental medication was administered in the control group to treat shivering and/or pain. In conclusion, administration of a high dose of tramadol at the end of surgery prevents post-anaesthetic shivering without prolongation of extubation time, and shortens the PACU/discharge-ready time.
这项前瞻性、随机双盲研究的目的是评估在手术结束时给予高剂量镇痛药物曲马多对拔管时间、镇静及麻醉后寒战的影响。40例ASA身体状况为I或II级的成年患者接受了约1小时的腹腔镜手术，并接受了以异氟烷维持于氧气/氧化亚氮中的标准化麻醉。在伤口缝合开始时静脉注射3mg/kg曲马多（n = 20），并与生理盐水组（n = 20）进行比较。接受曲马多的患者均未出现麻醉后寒战，而对照组中60%的患者出现了麻醉后寒战（P < 0.001）。对拔管时间和镇静无不良影响，曲马多组的准备出院时间更短（与对照组相比P < 0.05）。麻醉后护理单元（PACU）中的疼痛评分在两组间无统计学差异，但对照组为治疗寒战和/或疼痛给予了显著更多的补充药物。总之，手术结束时给予高剂量曲马多可预防麻醉后寒战，且不延长拔管时间，并缩短PACU/准备出院时间。
